Ultrasound-guided bilateral pulsed radiofrequency of the phrenic nerve for prolonged hiccups: a case report.

Singultus is the sudden onset of erratic diaphragmatic and intercostal muscle contraction immediately followed by laryngeal closure. Pathophysiology involves afferent, central and efferent components. Bilateral phrenic nerve block was performed to a 46-year-old woman with a brain tumor with persistent hiccups, with initially positive response but later symptom recurrence. Bilateral pulsed radiofrequency of the phrenic nerve was performed guided by ultrasonography (US). In the follow-up, absence of hiccups was confirmed. The patient was discharged 24 h later. Persistent or untreatable singultus is an infrequent condition that should not be dismissed. This approach is a safe, accurate and effective therapeutic approach for patient's refractory to conservative treatment. Further studies are needed to establish safety and effectiveness of the treatment.

Caracterización del ataque cerebrovascular isquémico agudo en el servicio de urgencias / Characterization of acute ischemic cerebrovascular accidents at the emergency department

Introducción: la enfermedad cerebrovascular (ECV) sigue siendo en el mundo la segunda causa de muerte. Colombia no cuenta con datos suficientes que permitan establecer diferencias en cuanto a los factores de riesgo y su curso clínico entre hombres y mujeres. Objetivo: caracterizar a los adultos hospitalizados con diagnóstico de enfermedad cerebrovascular isquémica (ECVI) atendidos en el Hospital de San José de Bogotá de marzo 1 de 2019 a enero 31 2020. Metodología: estudio tipo cohorte, descriptivo prospectivo, en mayores de 18 años con diagnóstico de ECVI. Resultados: se incluyeron 106 pacientes con edad media de 69 años, los factores de riesgo fueron inactividad física 87.1%, sobrepeso 40.6%, hipertensión 41.5% y exposición al cigarrillo 22.7%. Se evidenció en el angiotac algún grado de estenosis carotídea en 18% y fibrilación auricular en 5.6%. La mayoría recibió asa y atorvastatina (83.6%), 8.1% fueron anticoagulados y la mayoría presentó un ACV leve (62.6%), 19% de los pacientes fueron trombolizados y se logró establecer la ateroesclerosis como causa del ACV en 41.8%. Discusión y conclusiones: la ECV se presenta con más frecuencia a partir de la séptima década en la población activa, generando importantes discapacidades que limitan la funcionalidad. Existen factores de riesgo modificables, que debidamente manejados disminuyen el riesgo de ACV.

Introduction: cerebrovascular disease (CVD) is ranked as the second leading cause of death worldwide. In Colombia, there is scarce data to distinguish the risk factors and clinical course among men and women. Objective: to characterize inpatients with a diagnosis of ischemic cerebrovascular disease (ICVD) treated at Hospital de San José in Bogotá from March 1, 2019, to January 31, 2020. Methodology: a prospective, descriptive, cohort study in inpatients older than 18 years, diagnosed with ICVD, treated at Hospital de San José in Bogotá. Results: 106 patients with mean age 69 years, were included. Risk factors included physical inactivity 87.1%; overweight 40.6%, hypertension 41.5 % and tobacco smoke exposure 22.7%. A CT angiogram scan evidenced some degree of carotid stenosis in 18% and atrial fibrillation was identified in 5.6%. Most patients received acetylsalicylic acid and atorvastatin (83.6%); 8.1% received anticoagulation therapy and most of them presented a mild stroke (62.6%); 19% of patients received thrombolytic therapy. Atherosclerosis was established as the cause in 41.8%. Discussion and conclusions: cerebrovascular events mostly occur in the seventh decade of life and above, in the active population, causing significant disabilities with functional limitation. The proper management of risk factors that are modifiable can reduce the risk of a stroke.

Detection of changes in literary writing style using N-grams as style markers and supervised machine learning.

The analysis of an author's writing style implies the characterization and identification of the style in terms of a set of features commonly called linguistic features. The analysis can be extrinsic, where the style of an author can be compared with other authors, or intrinsic, where the style of an author is identified through different stages of his life. Intrinsic analysis has been used, for example, to detect mental illness and the effects of aging. A key element of the analysis is the style markers used to model the author's writing patterns. The style markers should handle diachronic changes and be thematic independent. One of the most commonly used style marker in extrinsic style analysis is n-gram. In this paper, we present the evaluation of traditional n-grams (words and characters) and dependency tree syntactic n-grams to solve the task of detecting changes in writing style over time. Our corpus consisted of novels by eleven English-speaking authors. The novels of each author were organized chronologically from the oldest to the most recent work according to the date of publication. Subsequently, two stages were defined: initial and final. In each stage three novels were assigned, novels of the initial stage corresponded to the oldest and those at the final stage to the most recent novels. To analyze changes in the writing style, novels were characterized by using four types of n-grams: characters, words, Part-Of-Speech (POS) tags and syntactic relations n-grams. Experiments were performed with a Logistic Regression classifier. Dimension reduction techniques such as Principal Component Analysis (PCA) and Latent Semantic Analysis (LSA) algorithms were evaluated. The results obtained with the different n-grams indicated that all authors presented significant changes in writing style over time. In addition, representations using n-grams of syntactic relations have achieved competitive results among different authors.

Mapping of Land Cover with Optical Images, Supervised Algorithms, and Google Earth Engine.

Crops and ecosystems constantly change, and risks are derived from heavy rains, hurricanes, droughts, human activities, climate change, etc. This has caused additional damages with economic and social impacts. Natural phenomena have caused the loss of crop areas, which endangers food security, destruction of the habitat of species of flora and fauna, and flooding of populations, among others. To help in the solution, it is necessary to develop strategies that maximize agricultural production as well as reduce land wear, environmental impact, and contamination of water resources. The generation of crop and land-use maps is advantageous for identifying suitable crop areas and collecting precise information about the produce. In this work, a strategy is proposed to identify and map sorghum and corn crops as well as land use and land cover. Our approach uses Sentinel-2 satellite images, spectral indices for the phenological detection of vegetation and water bodies, and automatic learning methods: support vector machine, random forest, and classification and regression trees. The study area is a tropical agricultural area with water bodies located in southeastern Mexico. The study was carried out from 2017 to 2019, and considering the climate and growing seasons of the site, two seasons were created for each year. Land use was identified as: water bodies, land in recovery, urban areas, sandy areas, and tropical rainforest. The results in overall accuracy were: 0.99% for the support vector machine, 0.95% for the random forest, and 0.92% for classification and regression trees. The kappa index was: 0.99% for the support vector machine, 0.97% for the random forest, and 0.94% for classification and regression trees. The support vector machine obtained the lowest percentage of false positives and margin of error. It also acquired better results in the classification of soil types and identification of crops.

Estado epiléptico en adultos: caracterización de pacientes monitorizados por videoelectroencefalograma / Status epilecticus in adults: patient characterization by video-electroencephalogram monitoringby video-electroencephalogram monitoring

Introducción: el estado epiléptico (EE) es una afección potencialmente mortal con una morbilidad significativa en quienes sobreviven a esta entidad. Pacientes y métodos: estudio transversal descriptivo de corte analítico con el objetivo de describir la prevalencia y la relación con variables sociodemográficas, electroencefalográficas, imagenológicas y desenlaces clínicos en los pacientes hospitalizados que fueron monitorizado por videoelectroencefalograma (VEEG), en el Hospital de San José de Bogotá, Colombia, entre agosto 2017 y agosto 2019. Resultados: de los 135 pacientes monitorizados por VEEG, 27,47% cumplieron con los criterios para EE. La edad promedio fue 48 (DE: 19,56) años, 54,05% (n=20) de sexo masculino y 75,67% (n=28) sin antecedentes de epilepsia. Predominaron las manifestaciones motoras (70,27%, n=26), en 59,46% en el puntaje STESS fue desfavorable, 64,86% (n=24) requirió inducción a coma y monitorización en la unidad de cuidados intensivos(UCI) y 37,84% (n=14) fallecieron durante su estancia intrahospitalaria. Se encontró una relación entre EE, requerimiento de UCI y muerte intrahospitalaria. Conclusiones: la prevalencia del EE en pacientes hospitalizados monitorizados por VEEG fue cercana a 28%, lo que sugiere una relación entre EE, requerimiento de UCI y muerte intrahospitalaria.

Introduction: status epilepticus (SE) is a life-threatening disorder associated with high morbidity in SE survivors. Patients and methods: descriptive and analytical cross-sectional study with the aim to characterize the prevalence and relation with socio-demographic, electroencephalography and neuro-image variables as well as clinical outcomes of hospitalized patients who received video-electroencephalogram (video-EEG) monitoring, at Hospital de San José in Bogotá, Colombia, between August 2017 and August 2019. Results: of the 135 patients who received video-EEG monitoring, 27.47% met the criteria for SE. The median age was 48 (SD: 19.56) years, 54.05% (n=20) were men and 75.67% (n=28) had no history of epilepsy. There was a predominance of motor manifestations (70.27%, n=26), 59.46% had an unfavorable STESS score, while 64.86% (n=24) required induced coma and monitoring in the intensive care unit (ICU) and 37.84 % (n=14) died during their hospital stay. A relationship was found between SE, requiring admission to the ICU and in-hospital death. Conclusions: the prevalence of SE in hospitalized patients monitored by video-EEG was close to 28%, and a relationship between SE, requiring ICU admission and in-hospital death is suggested.

Biomedical Signal Acquisition Using Sensors under the Paradigm of Parallel Computing.

There are several pathologies attacking the central nervous system and diverse therapies for each specific disease. These therapies seek as far as possible to minimize or offset the consequences caused by these types of pathologies and disorders in the patient. Therefore, comprehensive neurological care has been performed by neurorehabilitation therapies, to improve the patients' life quality and facilitating their performance in society. One way to know how the neurorehabilitation therapies contribute to help patients is by measuring changes in their brain activity by means of electroencephalograms (EEG). EEG data-processing applications have been used in neuroscience research to be highly computing- and data-intensive. Our proposal is an integrated system of Electroencephalographic, Electrocardiographic, Bioacoustic, and Digital Image Acquisition Analysis to provide neuroscience experts with tools to estimate the efficiency of a great variety of therapies. The three main axes of this proposal are: parallel or distributed capture, filtering and adaptation of biomedical signals, and synchronization in real epochs of sampling. Thus, the present proposal underlies a general system, whose main objective is to be a wireless benchmark in the field. In this way, this proposal could acquire and give some analysis tools for biomedical signals used for measuring brain interactions when it is stimulated by an external system during therapies, for example. Therefore, this system supports extreme environmental conditions, when necessary, which broadens the spectrum of its applications. In addition, in this proposal sensors could be added or eliminated depending on the needs of the research, generating a wide range of configuration limited by the number of CPU cores, i.e., the more biosensors, the more CPU cores will be required. To validate the proposed integrated system, it is used in a Dolphin-Assisted Therapy in patients with Infantile Cerebral Palsy and Obsessive-Compulsive Disorder, as well as with a neurotypical one. Event synchronization of sample periods helped isolate the same therapy stimulus and allowed it to be analyzed by tools such as the Power Spectrum or the Fractal Geometry.

Energy-Efficient Industrial Internet of Things Software-Defined Network by Means of the Peano Fractal.

The Industrial Internet of Things (IIoT) network generates great economic benefits in processes, system installation, maintenance, reliability, scalability, and interoperability. Wireless sensor networks (WSNs) allow the IIoT network to collect, process, and share data of different parameters among Industrial IoT sense Node (IISN). ESP8266 are IISNs connected to the Internet by means of a hub to share their information. In this article, a light-diffusion algorithm in WSN to connect all the IISNs is designed, based on the Peano fractal and swarm intelligence, i.e., without using a hub, simply sharing parameters with two adjacent IINSs, assuming that any IISN knows the parameters of the rest of these devices, even if they are not adjacent. We simulated the performance of our algorithm and compared it with other state-of-the-art protocols, finding that our proposal generates a longer lifetime of the IIoT network when few IISNs were connected. Thus, there is a saving-energy of approximately 5% but with 64 nodes there is a saving of more than 20%, because the IIoT network can grow in a 3 n way and the proposed topology does not impact in a linear way but log 3 , which balances energy consumption throughout the IIoT network.

Caracterización de pacientes con enfermedad cerebrovascular isquémica aguda / Characterization of acute ischemic cerebrovascular disease patientscerebrovascular disease patient

Introducción: dada la alta mortalidad asociada con la enfermedad cerebrovascular, es necesario conocer las características clínicas, factores de riesgo, causas del evento, tiempos de atención y tratamiento de los pacientes para implementar medidas que mejoren la detección y su tratamiento. Objetivo: caracterizar a los pacientes adultos hospitalizados con diagnóstico de enfermedad cerebrovascular isquémica atendidos en el Hospital de San José de Bogotá entre el 1 de junio de 2017 y 31 de mayo de 2018. Metodología: estudio descriptivo de corte transversal. Se incluyeron mayores de 18 años con diagnóstico de enfermedad cerebrovascular isquémica. La información se recolectó de las historias clínicas y se empleó estadística descriptiva para analizar los datos. Resultados: se incluyeron 160 pacientes. El tiempo de evolución tuvo una mediana de 9.9 horas, 85% de ellos ingresaron sin alteración de la conciencia y severidad leve. El tiempo puerta a imagen tuvo una mediana de 36 minutos y el de puerta a trombólisis de 72.5 minutos. Se realizaron neuroimágenes en la primera hora de ingreso a 65%, procedimientos de recanalización endovenosa a 13%, de arritmia cardíaca a 96% y de vasos carotídeos a 93%; 82.4% recibió terapia antiagregante y 76% lograron una marcha superior a 10 metros en el momento del egreso. Discusión y conclusiones: se requiere la realización de mejorías en los tiempos de atención para alcanzar las pautas establecidas en las guías internacionales actuales.

Introduction: due to the high mortality rates associated with cerebrovascular disease, knowledge on its clinical characteristics, risk factors, possible causes, time to initial care and treatment is required in order to implement measures to improve detection and treatment. Objective: to characterize adult patients admitted to Hospital de San José of Bogotá diagnosed with ischemic cerebrovascular disease between June 1 2017 and May 31 2018. Methodology: a descriptive cross-sectional study. Patients older than 18 years diagnosed with cerebrovascular disease were included. Relevant data was collected from clinical records and descriptive statistics were used for data analysis. Results: 160 patients were included. The median progression was 9.9 hours, 85% of patients were admitted presenting no alteration of consciousness and mild severity. The median door-to- imaging time was 36 minutes and door-to-thrombolytic therapy 72.5 minutes. Sixty-five percent of patients received neuroimaging within the first hour of admission, endovenous recanalization procedures were conducted in 13%; of cardiac arrhythmias to 96% and of carotid vessels to 93 %; 82.4% received antiplatelet therapy and 76% were able to walk more than 10 meters at dismissal. Discussion and Conclusions: reducing time until initial medical care is required to meet the currently established international guidelines

Improving Feature Representation Based on a Neural Network for Author Profiling in Social Media Texts.

We introduce a lexical resource for preprocessing social media data. We show that a neural network-based feature representation is enhanced by using this resource. We conducted experiments on the PAN 2015 and PAN 2016 author profiling corpora and obtained better results when performing the data preprocessing using the developed lexical resource. The resource includes dictionaries of slang words, contractions, abbreviations, and emoticons commonly used in social media. Each of the dictionaries was built for the English, Spanish, Dutch, and Italian languages. The resource is freely available.

Síndrome de coreelia de lange síndrome de brachmann-de lange / Fallopian tube carcinoma case presentation

Aún en nuestros días no se puede afirmar a ciencia cierta cual es la etiología del Síndrome de Cornelia de Lange aunque día a día se realizan avances en ese aspecto. El diagnóstico es clínico basándose en reconocer oportunamente los rasgos fenotípicos faciales característicos, retardo del crecimiento intrauterino y postnatal, anormalidades en las extremidades, y retraso mental. El rango y la severidad de estas alteraciones pueden variar mucho de unos casos a otros. En razón de la las múltiples necesidades y posibles complicaciones el manejo de estos pacientes debe ser multidisciplinario. Se presenta el caso de un niño admitido en el servicio de pediatría, del Hospital del niño Manuel Ascencio Villarroel de Cochabamba, Bolivia.

In our days it is not even possible to be affirmed for sure which is the etiology of the Cornelia de Lange's Syndrome although day to day advances are made in that aspect. The diagnostic is clinical being based on recognizing the fenotípics characteristic of face, retardation of the intrauterine and postnatal growth, abnormalities in the extremities, and mental delay. The rank and the severity of these alterations can vary much some cases to others. In regard to the multiple necessities and possible complications handling of these patients it must be multidisciplinary. The case of a boy admitted in the service of pediatric appears, of the Hospital del niño Manuel Ascencio Villarroel de Cochabamba, Bolivia.